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JKM > Volume 44(3); 2023 > Article
Jang, Park, Kim, and Lee: Chronologically Change and Importance of Acupuncture Points Used in Bell’s Palsy in Classical Literature

Abstract

Objectives

Many acupuncture points have been suggested for the treatment of Bell’s palsy, but information on which acupuncture points are more important in treatment is not provided. This study was conducted to investigate the importance of acupuncture points currently used clinically in Bell’s palsy.

Methods

By reviewing the full text of 11 books that recorded acupuncture prescriptions from the Qin Dynasty to the Qing Dynasty, the frequency of use of acupuncture points, their meridians, and their location were investigated.

Results

The average number of acupuncture points used for local, adjacent and distal points selection was 10.5, 2, 4 respectively. The number of acupuncture points increased from the Qin Dynasty to the Ming Dynasty 《Bojaebang》 and then decreased, but the proportion of local points has been still high. From the Ming Dynasty, ST4, ST6, GV26, and GV24 were mainly have been used as the local points. Except for the GB12, the use of the rest of the acupuncture points gradually decreased in the adjacent points. In the distal acupuncture points, it was summarized to point of lung and large intestine channel until the Ming Dynasty, and LI4 was mainly used in the Qing Dynasty. Yangming meridian has been most often used at the local and distal area except for the adjacent area.

Conclusions

In the treatment of facial paralysis, the lower part of the face had the highest proportion among local acupuncture points, and the Yangming had the highest proportion by meridian.

Fig. 1
Changes over time in the number of acupoints used in facial paralysis by literature
jkm-44-3-87f1.gif
Table 1
Published Age, Year and Terminology of Literature Related to Facial Paralysis.
Book Age Year Terminology*
鍼灸甲乙經 Qin Dynasties 282 口僻 厥口僻, 鼻窒口僻, 瘛瘲口僻, 瘛瘲口沫出, 喎僻, 口喎僻, 喎僻口不能言, 口僻不正, 口喎戾頸強, 口喎喘悸, 口喎
千金要方 Sui and Tang Dynasties 652 喎僻不能言, 口僻痛, 口不能噤水漿喎僻, 口緩不收
鍼灸資生經 Song Dynasties 1220 口面喎, 偏風口目喎, 口眼喎, 口喎, 偏風口喎, 失欠口喎, 口喎眼瞤動, 瘛瘲口喎, 瘛瘲口噼, 口僻, 口喎僻, 喎僻不能言, 口僻痛, 口不能噤水漿喎僻, 口眼喎斜
普濟方 Ming Dynasty 1406 口喎僻不能言, 僻風口喎, 口僻, 口喎僻, 喎僻不能言, 口僻痛, 口不能噤水漿喎僻, 口面喎, 偏風口目喎, 口眼喎, 口喎, 偏風口喎, 失欠口喎, 口喎眼瞤動, 瘛瘲口喎, 瘛瘲口噼, 口眼喎斜
神應經 Ming Dynasty 1425 口眼喎, 口喎眼喎
名醫類案 Ming Dynasty 1552 口喎
鍼灸大成 Ming Dynasty 1601 口喎眼喎, 口轉喎
證治準繩 Ming Dynasty 1602 口眼喎斜
類經圖翼 Ming Dynasty 1624 口眼喎斜
鍼灸易學 Qing Dynasty 1798 口眼喎斜
鍼灸集成 Qing Dynasty 1874 口眼喎斜

* Duplicated terms are described only once.

Table 2
Time Course of Acupoints Used in the Treatment of Facial Paralysis.
  • 1. 鍼灸甲乙經

  • 2. 千金要方

  • 3. 鍼灸資生經

  • 4. 普濟方

  • 5. 神應經

  • 6. 名醫類案

  • 7. 鍼灸大成

  • 8. 證治準繩

  • 9. 類經圖翼

  • 10. 鍼灸易學

  • 11. 鍼灸集成

Part Acupoint (International Code) Qin Dynasties Sui and Tang Dynasties Song Dynasties Ming Dynasty Qing Dynasty

Upper part of face 絲竹空 (TE23) 5, 7

Middle part of face 顴髎 (SI18) 1 2 3 4
下關 (ST7) 1 3 4
巨髎 (ST3) 1 2 3 4
上關 (GB3) 1 2 3 4
承泣 (ST1) 1 2 3 4, 8, 9
迎香 (LI20) 1 2 3 4
四白 (ST2) 2 3 4
顴骨 (N/A) 2 3 4
聽會 (GB2) 3 4, 9
和髎 (TE22) 3 4

Lower part of face 齦交 (GV28) 1 2 3 4
大迎 (ST5) 1 2 3 4 11
禾髎 (LI19) 1 2 3 4
水溝 (GV26) 1 2 3 4, 5, 7, 9 10
地倉 (ST6) 2 3 4, 5, 6, 7, 9 10
地倉 (ST4) 2 3 4, 5, 6, 7, 8, 9 10, 11
承漿 (CV24) 3 4, 7, 9 10, 11

Head & Neck 完骨 (GB12) 1 3 4, 9
翳風 (TE17) 1 3 4
强間 (GV18) 1 2 3 4
風池 (GB20) 2 3 4
承光 (BL6) 3 4
通天 (BL7) 3 4
百會 (GV20) 10

Limbs 太淵 (LU9) 1 3 5, 7
偏歷 (LI6) 1 3 4
行間 (LR2) 1 3 4, 5
內庭 (ST44) 3 4, 5
足三里 (ST36) 11
合谷 (LI4) 5, 7, 9 10, 11
列缺 (LU7) 3 4, 5, 7
衝陽 (ST42) 3 4
溫溜 (LI7) 3 4
二間 (LI2) 3 4, 5, 7
腹通谷 (KI20) 3 4, 5
間使 (PC5) 11
申脈 (BL62) 5
Table 3
Number of Acupoints Used for Facial Paralysis out of Total Acupoints on the Face
Meridian Upper Part Middle Part Lower Part Total

Acupoint Number Acupoint Number Acupoint Number
Large intestine meridian LI20 4 LI19 5 9

Stomach meridian ST8 0 ST1 8 ST4 18 61
ST2 3 ST5 8
ST3 8 ST6 13
ST7 3

Small intestine meridian SI18 6 6
SI19 0

Bladder meridian BL2 0 BL1 0 0

Triple energizer meridian TE23 2 TE21 0 4
TE22 2

Gallbladder meridian GB14 0 GB1 0 9
GB2 3
GB3 6

Governing vessel GV25 0 GV26 12 15
GV27 0
GV28 3

Conception vessel CV24 8 8

Total 2 43 67 112
Table 4
Frequency of Use of Facial Acupoints Used in Facial Paralysis.
Rank Acupoint International Code Muscle Number
1 地倉 ST4 orbicularis oris m., zygomaticus major m., levator anguli oris m. 18

2 頰車 ST6 masseter m. 13

3 水溝 GV26 orbicularis oris m. 12

4 承漿 CV24 orbicularis oris m., mentalis m. 8
大迎 ST5 masseter m.
巨髎 ST3 zygomaticus minor m., levator labii superioris m., levator angulioris m.
承泣 ST1 orbicularis oculi m., zygomatic m.

5 顴髎 SI18 zygomaticus major m., masseter m., buccinator m. 6
上關 GB3 masseter m., temporalis m.

6 禾髎 LI19 orbicularis oris m. 5

7 迎香 LI20 levator labii superioris m., levator anguli oris m. 4

8 下關 ST7 zygomaticus major m., masseter m., buccinator m. 3
四白 ST2 orbicularis oculi m., infraorbital m.
顴骨 N/A N/A
聽會 GB2 temporalis m.
齦交 GV28 orbicularis oris m.

9 絲竹空 TE23 orbicularis oculi m., temporalis m. 2
和髎 TE22 epicranius m. temporoparietal m.
Table 5
Frequency of Use of Acupoints in the Head and Neck and Limbs Used in Facial Paralysis.
Part Acupoint International Code Number
Head & Neck 完骨 GB12 6
强間 GV18 4
翳風 TE17 3
風池 GB20
承光 BL6 2
通天 BL7
百會 GV20 1

Limbs 列缺 LU7 7
合谷 LI4 6
太然 LU9 5
二間 LI2
偏歷 LI6 4
行間 LR2
內庭 ST44 3
腹通谷 KI20
衝陽 ST42 2
溫溜 LI7
足三里 ST36 1
間使 PC5
申脈 BL62

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